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TENANCY APPLICATION – ONLINE FORM

Please complete all questions

    PROPERTY APPLIED FOR:*

    HOW MANY APPLICANTS ARE THERE? 12

    APPLICANT 1: PERSONAL INFORMATION

    Forename(s):*

    Surname:*

    Previous Surname:

    Date of Birth:*

    NI No:*

    Mobile No:*

    Other Tel No:

    Email Address:*

    Current Address:*

    Time at current address*:

    APPLICANT 2: PERSONAL INFORMATION

    Forename(s):*

    Surname:*

    Previous Surname:

    Date of Birth:*

    NI No:*

    Mobile No:*

    Other Tel No:

    Email Address:*

    Current Address:*

    Time at current address:*

    APPLICANT 1: ABOUT YOUR WORK

    Name of Employer:

    Contact Name:

    Address of workplace:

    Tel No:

    Job Description:

    Start Date in this employment:

    Net Salary:

    APPLICANT 2: ABOUT YOUR WORK

    Name of Employer:

    Contact Name:

    Address of workplace:

    Tel No:

    Job Description:

    Start Date in this employment:

    Net Salary:

    How Many Children/ Dependants Will Be Living With You?

    DEPENDANT 1

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 1

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 2

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 1

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 2

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 3

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 1

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 2

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 3

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 4

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 1

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 2

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 3

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 4

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    DEPENDANT 5

    Surname:*
    Forename(s):*
    M/F:*MaleFemale
    D.O.B.:*
    Relationship:*

    APPLICANT 1: WELFARE BENEFITS

    Please Select All That Apply To You:JSAESADLA or PIPUCIncome SupportTax CreditsChild BenefitsOther

    JSA: per
    ESA: per
    DLA or PIP: per
    UC: per
    Income Support: per
    Tax Credits: per
    Child Benefits: per
    Other: per

    Have you been convicted of a criminal offence?YesNo

    Please Give Details:

    Do You Have Any CCJ's?*YesNo
    Do You Smoke?*YesNo
    Do You Have Any Pets?*YesNo

    Please State:

    APPLICANT 2: WELFARE BENEFITS

    Please Select All That Apply To You:JSAESADLA or PIPUCIncome SupportTax CreditsChild BenefitsOther

    JSA: per
    ESA: per
    DLA or PIP: per
    UC: per
    Income Support: per
    Tax Credits: per
    Child Benefits: per
    Other: per

    Have you been convicted of a criminal offence?YesNo

    Please Give Details:

    Do You Have Any CCJ's?*YesNo
    Do You Smoke?*YesNo
    Do You Have Any Pets?*YesNo

    Please State:

    APPLICANT 1: CURRENT LANDLORD DETAILS

    Landlord Name:*

    Address:*

    Tel No:*

    Start Date Of Tenancy:*

    Why Do You Wish To Move?*

    When do you wish to move?*

    Do you have any current rent arrears?*YesNo

    Have you ever had rent arrears?*YesNo

    Please Give Details:

    Will you be claiming Housing Benefit?*YesNo

    APPLICANT 2: CURRENT LANDLORD DETAILS

    Landlord Name:*

    Address:

    Tel No:*

    Start Date Of Tenancy:*

    Why Do You Wish To Move?*

    When do you wish to move?*

    Do you have any current rent arrears?*YesNo

    Have you ever had rent arrears?*YesNo

    Please Give Details:

    Will you be claiming Housing Benefit?*YesNo

    APPLICANT 1: PREVIOUS ADDRESSES

    How Many Previous Addresses Do You Have?*

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 2

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 2

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 3

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    APPLICANT 2: PREVIOUS ADDRESSES

    How Many Previous Addresses Do You Have?

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 2

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 1

    Previous Address 1:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 2

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    Address 3

    Previous Address 2:*
    Dates Lived There:*
    Landlord Name:*
    Contact Number:

    GUARANTOR DETAILS

    Please provide details of your proposed guarantor. This will be someone who is prepared to pay your rent if you or your Benefit does not pay.
    This should be a mature home owner or someone in a full time job.

    Forename(s):
    Surname:
    Current Address:
    Time at current address:
    Date of Birth:
    Mobile No:
    Other Tel No:
    Email:

    Home Owner:YesNo
    Employed:YesNo

    Name of Employer:
    Address of Employer:
    Employer Tel No:
    Job Description:
    Time Employed:

    Net Salary:


    DECLARATION

    I/we certify that the information given in this application is true.

    I/we understand that Platinum Lettings Limited reserve the right to take action for possession of any accommodation if it has been obtained by providing false or misleading information, whether deliberately or recklessly.

    I/we consent for Platinum Lettings Limited to obtain relevant information about me for the purposes of processing this application for Housing including a credit check.

    I/We agree for any necessary enquiries being made by or on behalf of Platinum Lettings Limited in order to confirm the details given on this form.

    I/We understand that the information provided on this form may be used to prevent and detect fraud.


    Applicant 1

    Signed:*
    Dated:*

    Applicant 2

    Signed:*
    Dated:*